血清C反应蛋白水平在克罗恩病中的改变

目的 比较血清C反应蛋白(CRP)水平在不同肠道疾病、不同病变部位和不同活动度中的变化,评估CRP作为疾病活动度指标的价值.方法 收集CD患者42例,分为结肠组25例和小肠组17例,另收集溃疡性结肠炎(UC)患者23例和肠易激综合征(IBS)患者26例作为对照组.胶乳增强免疫透射比浊法检测血清高敏(hs)-CRP水平.结果 ①CD、UC、IBS组hs-CRP均值分别为(9.9±7.8)mg/L、(3.6±4.5)mg/L、(1.1±1.8)mg/L,CD组显著高于UC组和IBS组,差异有统计学意义(P＜0.01),三组hs-CRP超过正常值患者的比率分别为76.2%、30.4%和7.7%,CD组亦显著高于UC组和IBS组,差异有统计学意义(P＜0.01).②在CD患者中,结肠组的hs-CRP显著高于小肠组[(11.9±7.6)mg/L比(6.8±7.2)mg/L,P=0.04);结肠组hs-CRP超过正常值患者的比率较小肠组高,但差异无统计学意义(P＞0.05).③CD患者中,hs-CRP≥10 mg/L者18例,其中疾病缓解(疾病活动指标＜150)4例(4/17),轻度(150～220)3例(3/11),中度(221～450)10例(10/13),重度(＞450)1例(1/1);hs-CRP与CD疾病活动指标、红细胞沉降率有显著相关性(r分别为0.52和0.70,P值均＜0.01).结论 CRP作为疾病活动指标主要用于CD,病变仅累及小肠者的CRP升高程度显著低于结肠病变者,CD病情愈重CRP升高愈明显.

Changes of serum C-reactive protein in patients with Crohn's disease

Objective To compare the changes of serum C reactive protein (CRP) in different lesion site and activity so as to evaluate its worthy of an indicator of disease activity. Methods Forty-two patients with Crohn's disease (CD) were divided into small intestinal group and colonic group according to the involved lesions. Twenty-three cases of UC and 26 cases of inflammatory bowel disease (IBS)were served as controls. The serum level of hs-CRP was tested using latex-enhanced immunoturbidimetery. mg/L and (1.1±1.8)mg/L, respectively. Hs-CRP was elevated significantly in CD group compared to UC and IBS groups (P＜0.001). The ratio of patients whose hs-CRP exceeded 3 mg/L was 76.2%, 30.4% and 7.7% in CD, UC and IBS, respectively (P=0.000). The ratio was significantly higher in CD higher than that of small intestinal group [(11.9±7.6 )mg/L vs (6.8±7.2)rag/L, P =0.04]. The ratio of patients whose hs-CRP exceeded normal value was higher in colonic group than that in small CRP(≥10 rag/L). Among them, 4/17 were in remission, 3/11 in mild, 10/13 in moderate and 1/1 in severe according to the CDAI. The hs-CRP was correlated well with CDAI and ESR (r was 0.52 and 0.70 respectively, P＜0.001). Conclusions CRP can he used as a inflammatory marker for evaluating the disease activity of CD. The patients with small intestinal involvment may have lower CRP than those with colonic affection. The elevation of CRP was paralleled to the disease severity of CD.